Health News - Secret Whittington A&E document revealed

Published: 27 May, 2010
by TOM FOOT

A SECRET report that led to unpopular plans to dismantle Whittington Hospital has finally been published.
Health chiefs hired the American consultancy firm McKinsey to advise them on how to run the NHS in London more efficiently.

The “elimination” of A&E departments was just one of a number of ideas proposed as well as scrapping outpatient appointments by a third and shortening doctor consultation times by an average of 20 per cent.

Requests to publish the documents under Freedom of Information laws were repeatedly rejected, on the grounds the report would be open to “potential misinterpretation”.

On Thursday, NHS London announced it was time to “draw a line in the sand” and publish the 159-page document.
It proposes shifting up to 60 per cent of A&E admissions into a web of “GP settings” or “polysystems” and “eliminating unnecessary and costly service overlaps – eg A&E” – with the aim of saving hospitals like the Whittington at least £29million.

A further £50million could be saved by finding ways of encouraging A&E patients to “self care”.
Outpatient appointments for low “value-added interventions” – such as grommets, joint replacements, and follow-ups – would be completely scrapped.
The figures have been challenged by clinical experts and, in two independent reports, one commissioned by the Department of Health, were found not to “stand up to scrutiny”.

Professor John Lister, author of the NHS on the Brink report commissioned by the British Medical Association, said: “The remarkable fact is that there is not a shred of evidence for any of these proposals in the report.

There is no narrative – it is just a series of ideas that is basically incomprehensible. Some of them are crazy. Who wrote this stuff? I am not convinced this is the real McKinsey report in its entirety.”

Former Labour minister Lord Darzi launched his Healthcare for London review in 2008. Billed as one of the biggest shake-ups of the NHS in decades, it ordered radical reforms to the London health map to meet a decrease in NHS funding.

A campaign opposing the changes was launched when a leaked memo revealed NHS bosses were considering closing the ­Whittington A&E department.

The new Health Secretary Andrew Lansley, within days of taking office, called an immediate halt to Lord Darzi’s review of the health service on Thursday.
He looks set to stick to his pre-election promise that, if he was elected, “the Whittington A&E would be saved”. An NHS London spokeswoman said on Friday: “NHS London would like to make it clear that there are no plans to downgrade A&E or maternity.”

The Darzi plan to break-up hospitals was criticised for allowing large profit-making firms to bid for new NHS contracts – local doctors found themselves priced out from the bidding process, which has cost surgeries more than £50,000.

In 2008, NHS Camden entered into talks with Virgin Healthcare about running a 70,000-patient super-surgery in University College London Hospital.

Care UK Ltd was chosen to run a health ­centre in Euston in 2009 and American health giant UnitedHealth won the contract to run three GP Camden surgeries.